Fertility rates across the Middle East and North Africa (Mena) are in decline, partly for socio-economic reasons and increasingly due to the increasing prevalence of chronic diseases like diabetes. The UAE for example, currently has one of the lowest fertility rates in the world, with just 1.37 children per woman in 2020 compared to 6.58 in 1971 according to Knoema. Helping to address problems unique to women’s health is a growing number of feminine health technology (femtech) startups, whose focus can range from fertility and period-tracking apps to pregnancy care and sexual wellness.
Last year, the femtech sector attracted $1.2 billion around the world and is set to be worth $50 billion by 2025 according to research firm Frost & Sullivan. Regionally, a third of all femtech startups are based in the UAE, and chief among them is Nabta Health, a platform that provides health insights and diagnostic services on issues surrounding fertility, conception, and overall female health. The company has just closed a $1.5 million Seed round, led by Basim Anwer of Regionality Group of Companies, with participation from notable angel investors including Priya Oberoi, founding general partner of Goddess Gaia Ventures, Sarper Tanli, operating partner of TVM Capital Healthcare, and Nadia Mannell, founding general partner of Seed South Capital. Existing investors also participated in the round.
“Women in emerging markets need access to holistic healthcare, particularly in the context of infertility, because of the growing prevalence of chronic diseases,” says Sophie Smith, who founded Nabta Health in 2017 to provide women across Middle Eastern, African, and South Asian populations access to tools that can reduce the time it takes to detect, diagnose and treat chronic diseases by combining digital and traditional healthcare.
It takes on average two and a half years and three doctors to diagnose polycystic ovarian syndrome and seven years for endometriosis. Nabta’s technology “reimagines the clinical pathway from symptom to diagnosis” to cut down diagnosis time to mere weeks at which point the user’s healthcare needs are handed over to their clinician while Nabta continues to provide dietary, lifestyle and healthcare advice to the user through its app.
The company has spent the past few years in its research and development (R&D) phase and will now use the investment to expand its product portfolio to include B2B offerings, hire new talent and expand its market share in the UAE.
“The femtech market is still very, very nascent in the emerging markets. Fewer than 1 per cent of femtech companies target countries such as the UAE and Saudi, despite there being a sizeable, largely untapped market opportunity and a real human need. Nabta Health is in a unique position now to be the leader in femtech health and wearables in the GCC, and we are excited with what the future holds for us,” says Smith.
Last year, 47 healthtech startups in Mena raised in excess of $64 million, of which only one was in the femtech space. While overall investment records were smashed last year in the region, with startups raising $2.87 billion, just 1.2 per cent of that went to startups founded by women. For femtech startups globally, raising investment is a tough challenge.
"Raising our Seed round has been a time-consuming process. We tried opening the round during Covid, but people were cautious about investing in femtech. In the healthcare sector they [investors] were only interested in Covid-related healthtech, companies like ours couldn’t do very much so we reopened the round in March 2021, it took us 10 months to close," says Smith.
Back when the company was raising its Seed round, the VC ecosystem in the Middle East “was not really interested. We spoke to most of the local funds here and the response we received was that it was too early [to invest]. Despite the traction and all the unique insights we have about women's health in the MENA region, there wasn’t really any interest. In Q4 last year I followed up with a couple of the local funds, but most of the others I gave up on for this round".
The difficulty in raising investment is “a combination of things”, according to Smith. “As a company, we compound a number of issues: I am a solo female founder, solo founders in the ecosystem are regarded with caution; we are female-oriented – there aren’t very many female-oriented companies that have been invested in outside of the e-commerce space; we are a deeptech company that went through R&D - there is limited funding available for companies going through R&D.”
Part of the problem is also the low cultural transparency and interest in issues regarding female health. Throughout the world, men are typically seen as the default, with clinical trials relying mostly on male volunteers. Research focusing solely on women’s health issues also receive less funding, despite women accounting for half of the world's population. This results in a skewed and limited understanding of female health in the medical and wider world.
“We were told to relocate to the US or UK if you want to succeed, but we want to address the systematic racial inequalities in healthcare, and we can only do that by operating in a market where those who have historically been underserved - women of Middle Eastern, African and South Asian origin - make up the majority of the population," she says. “I believe the region is coming around, we’ve seen that with other sectors. It was an unprecedentedly good year for femtech in the US and Europe last year, and so it is a matter of surviving long enough and being in the right place at the right time.”
Nabta is expecting to open its Series A round in December this year, with plans to expand to Saudi Arabia.
“People are now becoming very interested in where we are and what we've become, we just had to survive," says Smith.